- Issue 33 - 2011 Fee Schedule Update The following bulletin contains important information regarding upcoming fee schedule changes for BlueShield of Northeastern New York.
- Issue 32 - Pharmacy Guideline Updates As a result of the quarterly review performed by our Pharmacy and Therapeutics Committee, the following Pharmacy Guideline changes will become effective February 1, 2011.
- Issue 31 - Medicare Part B Drug Claims As an essential partner in our members’ health care, BlueShield of Northeastern New York wants you to be aware of an important change specific to the processing of Medicare Part B drug claims (usually J codes), effective January 1, 2011.
- Issue 30 - Announcing a New Medicare Advantage Product for 2011 The new BlueSaver MSA plan combines a high deductible plan with a medical savings account that Medicare Advantage members can use to pay for their health care costs while meeting their annual deductible of $4,400.
- Issue 29 - Durable Medical Equipment Update The updated Durable Medical Equipment (DME), Prosthetic and Orthotic preauthorization requirements for BlueShield of Northeastern New York are effective January 1, 2011.
- Issue 28 - 2010 Quality Compliance Reports Now Available Online Reports for the first half of 2010 are now available on our secure provider web site at www.bsneny.com.
- Issue 27 - Pharmacy and Medical Guideline Updates The attached Pharmacy and Medical Guideline updates are effective December 1, 2010. These updates are a result of the annual guideline review and new drug evaluations performed quarterly by our Pharmacy & Therapeutics Committee.
- Issue 26 - Appropriate Use of Modifiers Providers are reminded to adhere to the Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) guidelines when billing, regardless of reimbursement potential.
- Issue 25 - New HIV Testing Law in New York State Effective September 1, 2010, the new law will provide significant changes in human immunodeficiency virus (HIV) testing guidelines in New York state.
- Issue 24 - Patient-Centered Medical Home Beginning in 2011, BlueShield of Northeastern New York will provide enhanced per member per month (pmpm) payments ranging from $.50 to $2.00 pmpm (for most lines of business) to any practice that has attained Level One, Two or Three Recognition by NCQA.
- Issue 23 - Hospice Billing Change for Medicare Advantage Effective November 1, 2010, BlueShield of Northeastern New York expects all providers to comply with the new billing practice outlined in the CMS publication and summarized below.
- Issue 22 - Preauth Requirements Change Reminder Effective June 30, 2010, preauthorization of the first 20 outpatient treatments/visits mental health or substance abuse services is no longer required for most contracts.
- Issue 21 - Breastfeeding Mothers’ Bill of Rights Effective May 1, 2010, the New York State Legislature passed the Breastfeeding Mothers’ Bill of Rights. The intent is to provide complete information regarding the health benefits of breastfeeding so that mothers can make an informed choice.
- Issue 20 - Behavioral Health Fee Schedule Increase BlueShield of Northeastern New York is pleased to announce an increase in the corporate behavioral health fee schedules effective with dates of service on or after July 1, 2010.
- Issue 19 - Pharmacy and Medical Guideline Updates As a result of the annual guideline review performed by our Pharmacy & Therapeutics Committee, attached to this bulletin are Pharmacy and Medical Guideline updates effective September 1, 2010.
- Issue 18 - Medical Services Protocol Update Clinical Protocol updates which include information about changes made to some of our Protocols after a recent review.
- Issue 17 - Preferred Viscosupplementation Therapy Update Effective immediately, Euflexxa®, Synvisc®, and Synvisc-One® are the preferred agents under BlueShield medical coverage. Current preauthorization requirements remain in effect.
- Issue 16 - Back Care Program to Begin in August In order to meet the needs of our members who suffer from chronic back pain, we have created a comprehensive case and disease management program.
- Issue 15 - Medical Services Protocol Update Effective August 1, 2010, BlueShield of Northeastern New York has a new protocol that states scintimammography or breast-specific gamma imaging (BSGI) is investigational for all applications.
- Issue 14 - Preauthorization Requirement BlueShield of Northeastern New York is pleased to announce that, effective June 30, 2010, preauthorization of the first 20 outpatient mental health or substance abuse services is no longer required for most contracts.
- Issue 13 - Free e-Prescribing System Available to You HIXNY is offering physicians an e-prescribing system, free of charge, for 2010.
- Issue 12 - Pharmacy and Medical Guideline Updates These Pharmacy and Medical Guideline updates will become effective as of July 1, 2010.
- Issue 11 - Pay for Performance Update We are pleased to announce that your Quality Compliance Reports are now available on our secure provider web site.
- Issue 10 - Updated Timely Filing Policy The following is important information regarding recent New York State Managed Care regulations.
- Issue 09 - Lead Screening Tests BlueShield of Northeastern New York will provide reimbursement for "point-of-care" blood testing for lead in children less than six years of age and pregnant women when performed by participating providers with the appropriate certification
- Issue 08 - Pay for Performance Update The following bulletin contains important information regarding updates to the Pay for Performance program.
- Issue 07 - 2010 Fee Schedule Update The following bulletin contains information regarding BlueCross BlueShield of Western New York’s upcoming fee schedule changes.
- Issue 06 - Medical Services Protocol Updates This clinical Protocol update includes information on a Protocol that has recently had an annual review resulting in a revision to the guidelines. This summary also includes a new Protocol.
- Issue 05 - Computer-Assisted Surgical Navigation Procedures This notice contains important information regarding Computer-Assisted Surgical Navigation Procedures.
- Issue 04 - Maternity Physician Practice Guidelines Update This notice contains important information regarding Agency for Healthcare Research and Quality recommendations.
- Issue 03 - Updated Registration Process for Hospital-Based Practitioners The following information is provided as a courtesy in order to make it easier for non-credentialed practitioners to participate with BlueShield of Northeastern New York.
- Issue 02 - New Online Reports Available BlueShield of Northeastern New York is pleased to announce that on Friday, January 22, 2010, two reports will be available via our secure provider web site.
- Issue 01 - Preauthorization Required for Hospital Admissions Effective February 15, 2010, all hospital admissions and confinements will be subject to preauthorization and medical review.
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